Utilizing head motion measurements integrated with clinical outcomes to inform post-concussion return to play protocols in gymnastics

利用头部运动测量与临床结果相结合，为体操中脑震荡后恢复比赛方案提供信息

• 批准号: 10433034
• 负责人: Jillian Elizabeth Urban
• 金额: $ 22.85万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-14 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10433034
• 关键词: Acceleration; Acute; Address; Affect; Age; American; Area; Assessment tool; Back; Biomechanics; Body Regions; Brain Concussion; Caring; Clinical; Clinical Assessment Tool; Clinical assessments; Cognition; Communities; Community Medicine; Complex; Craniocerebral Trauma; Data; Development; Discipline; Elements; Emergency department visit; Enrollment; Environment; Equilibrium; Evaluation; Event; Exposure to; Female; Frequencies; Goals; Gymnastics; Head; Head Movements; Height; Hospitals; Impairment; Injury; Investigation; Knowledge; Lead; Manufactured Baseball; Measurement; Measures; Memory; Modeling; Modification; Monitor; Motion; Musculoskeletal Equilibrium; Neurocognitive; Outcome; Participant; Play; Positioning Attribute; Protocols documentation; Recommendation; Recovery; Recreation; Research; Research Project Grants; Rotation; Safety; Series; Severities; Sports; Sports Medicine; Surface; Symptoms; Traumatic Brain Injury; United States; Weight; Youth; base; behavior measurement; college; design; experience; falls; head impact; high risk; high school; improved; instrument; kinematics; male; motion sensor; motor impairment; motor symptom; novel; oculomotor; research study; sex; skills

Project Summary/Abstract Gymnastics is a leading cause of head injury among sports- and recreation-related activities and is the second most common cause of emergency room visits for non-fatal traumatic brain injury among non-contact sports. As a sport, gymnastics is composed of six disciplines that utilize various skills to showcase balance, power, and artistry. The physical demands of the sport often lead to a variety of injuries, including concussion. Concussions in gymnastics commonly occur from falls and missed landings, but gymnasts are also exposed to direct (contact) and inertial (non-contact) accelerations of the head while performing complex skills that are generally not associated with concussion but may affect recovery following concussion. Additionally, athletes may experience impairments to memory, concentration, and vestibular/ocular-motor symptoms following concussion, but effects from repetitive rotational head movements, such as those experienced by gymnasts, are not well-understood. With ~ 5 million Americans participating in gymnastics-related activities, there is a critical need to understand the head accelerations experienced by gymnasts and their relationship to concussion-related clinical outcomes to inform safety recommendations, including post-concussion return to play protocols, in the sport. The objective of this study is to characterize kinematics (i.e., accelerations, velocity) of the head across skills performed in artistic gymnastics and their relationship to concussion-related clinical outcomes and evaluate the effect of safety modifications on reducing kinematic loads experienced by gymnasts. In Aim 1, 16 beginner-level (8 male, 8 female) and 16 advanced-level (8 male, 8 female) artistic gymnasts (ages 11-15) will be fitted with mouthpiece- based head motion sensors. Biomechanical data will be collected and quantified during all practices to determine the frequency, magnitude, and duration of head accelerations experienced during normal participation of the sport. In Aim 2, we will engage stakeholders in the gymnastics and sports medicine communities to identify and evaluate skill-specific safety modifications to reduce head kinematics in gymnastics. Enrolled gymnasts will complete a series of skills with two progressive safety modifications; the effect of safety modifications on reducing head accelerations will be evaluated. In Aim 3, the relationship between exposure to head accelerations during normal participation of gymnastics and concussion-related clinical outcomes will be evaluated. Changes in pre- to post-study cognition and postural control and acute changes in concussion-related symptoms will be monitored using validated clinical assessment tools and evaluated with respect to head acceleration measuring during the study. This R21 exploratory/developmental research study seeks to ultimately change the paradigm of concussion safety in gymnastics and will result in key data to support a large-scale study to develop and evaluate a biomechanically-informed return to play protocol for gymnastics. This approach will provide a framework that may be expanded to other disciplines of gymnastics and acrobatic sports to improve the safety of over 5 million athletes participating in acrobatic activities.

项目摘要/摘要 体操是体育和娱乐相关活动中头部受伤的主要原因，是第二个 急诊室访问非致命性脑损伤的最常见原因。作为 一项运动，体操由六个学科组成，利用各种技能来展示平衡，力量和 艺术性。这项运动的身体需求通常会导致各种伤害，包括脑震荡。脑震荡 在体操中，通常是从秋天出现的，错过着陆，但体操运动员也暴露于直接（联系） 和惯性（非接触）的头部加速度，同时执行通常不是的复杂技能 与脑震荡有关，但可能会影响脑震荡后的恢复。此外，运动员可能会经历 脑震荡后记忆，集中和前庭/眼部运动症状的损害，但影响 从重复的旋转头部移动中，例如体操运动员经历的动作并没有得到很好的理解。 大约有500万美国人参加与体操有关的活动，因此至关重要的是要了解 体操运动员经历的头部加速及其与脑震荡有关的临床结果的关系 在这项运动中为安全建议提供，包括脑后召回播放方案的恢复。目标 这项研究的特征是表征运动学的运动学（即加速度，速度）跨越 艺术体操及其与脑震荡有关的临床结果的关系，并评估安全的影响 修改减少体操运动员经历的运动学负荷。在AIM 1，16个初学者级别（8个男性，8个 女性）和16个高级级别（8个男性，8位女性）艺术体操（11-15岁）将配有喉舌 - 基于头部运动传感器。在所有实践中，将收集和量化生物力学数据，以确定 在正常参与期间经历的频率，大小和持续时间 运动。在AIM 2中，我们将与体操和运动医学社区中的利益相关者识别和 评估特定于技能的安全性修改，以减少体操中的头部运动学。入学的体操运动员会 通过两种进行性安全修改完成一系列技能；安全修改对减少的影响 将评估头部加速度。在AIM 3中，在接触头加速度之间的关系 将评估体操和与脑震荡有关的临床结果的正常参与。前的变化 在研究后认知和姿势控制以及与脑震荡有关的症状的急性变化将是 使用经过验证的临床评估工具监控，并对头部加速度测量进行评估 在研究期间。这项R21探索/发展研究旨在最终改变范式 在体操中的脑震荡安全性，并将产生关键数据，以支持一项大规模研究以发展和 评估生物力学信息的返回播放体操协议。这种方法将提供 可以扩展到其他体操学科和杂技运动的框架，以提高安全性 超过500万运动员参加杂技活动。